自我测量血压与动态血压在高血压诊断中的应用

Self-measured versus ambulatory blood pressure in the diagnosis of hypertension.

作者信息

Hond Elly Den, Celis Hilde, Fagard Robert, Keary Louis, Leeman Marc, O'Brien Eoin, Vandenhoven Guy, Staessen Jan A

机构信息

Study Coordinating Centre, Hypertension and Cardiovascular Rehabilitation Unit, Department of Molecular and Cardiovascular Research, Katholieke Universiteit Leuven, Belgium.

出版信息

J Hypertens. 2003 Apr;21(4):717-22. doi: 10.1097/00004872-200304000-00014.

DOI:10.1097/00004872-200304000-00014

PMID:12658017

Abstract

OBJECTIVE

We examined to what extent self-measurement of blood pressure at home (HBP) can be an alternative to ambulatory monitoring (ABP) to diagnose white-coat hypertension.

METHODS

In 247 untreated patients, we compared the white-coat effects obtained by HBP and ABP. The thresholds to diagnose hypertension were > or = 140/> or = 90 mmHg for conventional blood pressure (CBP) and > or = 135/> or = 85 mmHg for daytime ABP and HBP.

RESULTS

Mean systolic/diastolic CBP, HBP and ABP were 155.4/100.0, 143.1/91.5 and 148.1/95.0 mmHg, respectively. The white-coat effect was 5.0/3.5 mmHg larger on HBP compared with ABP (12.3/8.6 versus 7.2/5.0 mmHg; P < 0.001). The correlation coefficients between the white-coat effects based on HBP and ABP were 0.74 systolic and 0.60 diastolic (P < 0.001). With ABP as a reference, the specificity of HBP to detect white-coat hypertension was 88.6%, and the sensitivity was 68.4%.

CONCLUSION

Our findings are in line with the recommendations of the ASH Ad Hoc Panel that recommends HBP for screening while ABP has a better prognostic accuracy.

摘要

目的

我们研究了家庭自测血压（HBP）在多大程度上可以替代动态血压监测（ABP）来诊断白大衣高血压。

方法

在247例未经治疗的患者中，我们比较了通过HBP和ABP获得的白大衣效应。诊断高血压的阈值为常规血压（CBP）≥140/≥90 mmHg，日间ABP和HBP≥135/≥85 mmHg。

结果

平均收缩压/舒张压CBP、HBP和ABP分别为155.4/100.0、143.1/91.5和148.1/95.0 mmHg。与ABP相比，HBP的白大衣效应收缩压/舒张压高5.0/3.5 mmHg（12.3/8.6对7.2/5.0 mmHg；P<0.001）。基于HBP和ABP的白大衣效应之间的相关系数收缩压为0.74，舒张压为0.60（P<0.001）。以ABP为参照，HBP检测白大衣高血压的特异性为88.6%，敏感性为68.4%。